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PHCY310 Test sobre L35,36,37 CKD Pharmacology, Therapeutics, Labs, creado por Mer Scott el 16/04/2019.

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L35,36,37 CKD Pharmacology, Therapeutics, Labs

Pregunta 1 de 13

1

Three determinants of renin release:
1. Decreased sensed by kidney
2. Decreased BP or renal
3. receptor activation

Arrastra y suelta para completar el texto.

    Na+ concentration
    blood flow
    Beta 2

Explicación

Pregunta 2 de 13

1

Angiotensin causes profound vasoconstriction and aldosterone release.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 3 de 13

1

Both ACEIs and ARBS will decrease systemic vascular resistance and increase renal perfusion.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 4 de 13

1

Diuretics for CKD:
1. Loop diuretics inhibit the activity of the Na-K-2Cl symporter in the . Therefore maximum
effect is ~%.
2. Thiazide diuretics inhibit the activity of the Na-Cl symporter in the . Maximum effect is ~%.
3. K-sparing diuretics inhibit the activity of epithelial Na+ channels in the . Maximum effect is ~%.
4. Aldosterone antagonists competitively inhibit the binding of to the mineralocorticoid receptor. The only class of diuretics that do not enter the tubule cell from the apical () side, and instead from the basolateral () side.

Arrastra y suelta para completar el texto.

    thick ascending loop of Henle
    20-25
    distal tubule
    5
    late distal tubule and collecting duct
    2
    aldosterone
    blood
    tubular

Explicación

Pregunta 5 de 13

1

Classification of CKD:
• Normal/ CKD 1: GFR >90 mL/min
• Mild/ CKD 2: GFR mL/min
• Moderate/ CKD 3: GFR mL/min
• Severe/ CKD 4: GFR mL/min
• End-stage/ CKD 5: GFR <15 mL/min

Arrastra y suelta para completar el texto.

    60-90
    30-60
    15-30

Explicación

Pregunta 6 de 13

1

Non-pharmacological treatment of CKD entails dietary sodium restriction, and protein restriction if GFR < 30mL/min.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 7 de 13

1

When using ACEIs and ARBs in CKD the target is a reduction in urine of 30-50%. Starting can GFR; start at a dose and titrate the dose slowly to effect. Other Important side effects to consider:
kalaemia
renal impairment
• Dry cough (fairly )
• Angioedema (, but serious)

Arrastra y suelta para completar el texto.

    albumin
    reduce
    low
    Hyper
    Acute
    common
    rare

Explicación

Pregunta 8 de 13

1

Methods of estimating renal function:
1. Creatinine-based methods (CLcr, eGFR)
• Collection of 24 hour urine samples ( clearance)
• Cockcroft-Gault (an estimate of creatinine clearance)
• MDRD
• CKD-EPI
All these are reported by the lab as “”.
2. Cystatin C clearance
3. Clearance of a : Inulin (NOT insulin), 51Cr EDTA (radioisotope)

Arrastra y suelta para completar el texto.

    creatinine
    Equation
    eGFR
    xenobiotic

Explicación

Pregunta 9 de 13

1

Creatinine is freely filtered by the glomerulus and so its clearance lets us estimate GFR.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 10 de 13

1

Cockcroft & Gault equation:
CLcr = ( (140 - ) x x K* ) /

* K = 1.23 for males, 1.04 for females

Arrastra y suelta para completar el texto.

    age
    ideal body weight
    serum creatinine

Explicación

Pregunta 11 de 13

1

All creatinine-based methods;
• Are poor predictors of GFR if malnourished or low mass
• Over-estimate GFR in the elderly, (using total body weight), severe or end-stage renal disease
• Not for < years old
• Unreliable when renal function rapidly (acute renal failure)
• Drugs tubular secretion can raise creatinine conc (e.g. probenecid, trimethoprim, spironolactone)

Arrastra y suelta para completar el texto.

    muscle
    18
    changing
    obese
    inhibiting

Explicación

Pregunta 12 de 13

1

In CKD, K+ secretion is resulting in accumulation. Concentrations above mmol/L become symptomatic. Hyperkalaemia is more likely to be observed in CKD 4 or 5, and is exacerbated by and K-sparing diuretics.

Arrastra y suelta para completar el texto.

    reduced
    5.5-6
    ACE-I, ARBs

Explicación

Pregunta 13 de 13

1

Match the ranges.
- Creatinine (plasma): Adult male: 50- µmol/L, Adult female: 45- µmol/L
- Urea (plasma): Adults: mmol/L
- Sodium (plasma) mmol/L
- Osmolality (plasma) 280- mmol/kg
- Osmolality (urine) 300- mmol/kg

Arrastra y suelta para completar el texto.

    110
    90
    3.2-7.7
    135-145
    300
    1200

Explicación